Obstructive sleep apnea severity affects amyloid burden in cognitively normal elderly a longitudinal study

Recent evidence suggests that Obstructive Sleep Apnea (OSA) may be a risk factor for developing Mild Cognitive Impairment and Alzheimer’s disease. However, how sleep apnea affects longitudinal risk for Alzheimer’s disease is less well understood.Postprint (author's final draft

Prevalence of sleep disorders in adults with down syndrome: A comparative study of self-reported, actigraphic, and polysomnographic findings

Study Objectives: Sleep problems are often undetected in adults with Down syndrome (DS). Our objective was to determine the prevalence of sleep disorders in adults with DS through self-reported and objective sleep measures. Methods: We performed a community-based cross-sectional study of 54 adults with DS not referred for sleep disorders. Two polysomnography (PSG) sleep studies were performed. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI); daytime sleepiness was evaluated using the Epworth Sleepiness Scale (ESS) and the risk for the sleep apnea syndrome (OSA) was identified using the Berlin Questionnaire (BQ). Participants’ sleep/wake pattern was assessed from sleep diaries and by wrist actigraphy. PSQI, ESS, and PSG measures were compared with 35 sex-, age-, and body mass index-matched patients in the control groups. Results: In PSG measures, adults with DS showed lower sleep efficiency (69 ± 17.7 versus 81.6 ± 11; P < .001), less rapid eye movement sleep (9.4 ± 5.8 versus 19.4 ± 5.1; P < .001), a higher prevalence of OSA (78% versus 14%; P < .001), and a higher apnea-hypopnea index (23.5 ± 24.5 versus 3.8 ± 10.5; P < .001) than patients in the control group. In the DS group, the questionnaires (mean PSQI 3.7 ± 2.9; mean ESS 6.3 ± 4.5 and mean BQ 1 ± 0) did not reflect the sleep disturbances detected on the PSG. Actigraphy data recorded daytime sleep that was not self-reported (118.2 ± 104.2 minutes). Conclusions: Adults with DS show severe sleep disruption and a high prevalence of OSA, undetected by self-reported sleep measures. Actigraphy, PSG, and validated simplified devices for screening OSA should be routinely recommended for this population because treatment of sleep disorders can contribute to healthy aging.Postprint (published version

Influence of metallic artifact filtering on MEG signals for source localization during interictal epileptiform activity

Objective. Medical intractable epilepsy is a common condition that affects 40% of epileptic patients that generally have to undergo resective surgery. Magnetoencephalography (MEG) has been increasingly used to identify the epileptogenic foci through equivalent current dipole (ECD) modeling, one of the most accepted methods to obtain an accurate localization of interictal epileptiform discharges (IEDs). Modeling requires that MEG signals are adequately preprocessed to reduce interferences, a task that has been greatly improved by the use of blind source separation (BSS) methods. MEG recordings are highly sensitive to metallic interferences originated inside the head by implanted intracranial electrodes, dental prosthesis, etc and also coming from external sources such as pacemakers or vagal stimulators. To reduce these artifacts, a BSS-based fully automatic procedure was recently developed and validated, showing an effective reduction of metallic artifacts in simulated and real signals (Migliorelli et al 2015 J. Neural Eng. 12 046001). The main objective of this study was to evaluate its effects in the detection of IEDs and ECD modeling of patients with focal epilepsy and metallic interference. Approach. A comparison between the resulting positions of ECDs was performed: without removing metallic interference; rejecting only channels with large metallic artifacts; and after BSS-based reduction. Measures of dispersion and distance of ECDs were defined to analyze the results. Main results. The relationship between the artifact-to-signal ratio and ECD fitting showed that higher values of metallic interference produced highly scattered dipoles. Results revealed a significant reduction on dispersion using the BSS-based reduction procedure, yielding feasible locations of ECDs in contrast to the other two approaches. Significance. The automatic BSS-based method can be applied to MEG datasets affected by metallic artifacts as a processing step to improve the localization of epileptic foci.Postprint (published version

Estudi de la connectivitat cerebral durant la vigília prolongada

En aquest estudi s’avaluen els efectes de la privació de son sobre el senyals electroencefalogràfics de voluntaris sans mitjançant la transferència d’entropia (TE), una tècnica no paramètrica que permet detectar dependències direccionals entre variables. El resultats obtinguts concorden amb la potència en la banda θ, un marcador reconegut relacionat amb la pressió de son. Els màxims efectes de la privació de son es produeixen després de 24 hores sense dormir, període en el qual es produeixen increments de TE localitzats en la regió anterior del cap, mentre que es produeixen disminucions que afecten tot el crani. El valor mitjà d’aquestes disminucions mostra una correlació alta amb la potència theta, de manera que es pot considerar un marcador fiable de la pressió de son, alhora que aporta informació sobre la localització dels canvis produïts i indica una disminució global de la transferència d’informació entre zones

Assessment of the pharmacological effects of alprazolam on electroencephalography using connectivity indexes not affected by volume conduction

Electroencephalographic analysis techniques have become a very useful tool to assess brain activity and interactions between cerebral regions, that is, the so-called cerebral connectivity analysis. The effects of some drugs have, so far, been studied using spectral analysis and, to a lesser extent, some linear and nonlinear connectivity techniques. New indexes have recently been designed based on assumptions that make them more robust against volume conduction effects that could yield to spurious connectivity results. These new indexes such as the imaginary coherence (IC) [Nolte et al., 2004], the phase-lag index (PLI) [Stam et al., 2007] and the weighted phase-lag index (WPLI) [Vinck et al., 2011] have proven very useful in several fields, for example in characterizing electroencephalographic (EEG) and magnetoencephalographic (MEG) activity of Alzheimer’s Disease patients compared to healthy controls. However, these techniques have not been applied to study the effect of drugs on the brain. The main purpose of the current work was to assess the suitability and effectiveness of these innovative indexes to study the brain connectivity under psychoactive drug treatment, and concretely, the effects of a single dose of alprazolam, a short-acting drug of the benzodiazepine family. Alprazolam is extensively prescribed for the treatment of anxiety and panic disorders, and peak plasma concentrations are obtained between 0.5 and 2 hours after intake [Greenblat and Wright, 1993]. Being a benzodiazepines, alprazolam induces an enhancement of the inhibitory pathways through their activity on the GABA A receptor complex, favouring the entrance to chloride ions into the neurons [Haefely, 1990]. Due to the enhancement of the inhibitory pathways a weakening or even an impairment of functional connectivity could be hypothesizedPostprint (author's final draft

Estudio de la conectividad cerebral mediante transferencia de entropía

En el presente trabajo se estudian los efectos de la privación del sueño sobre las señales electroencefalográficas de voluntarios sanos mediante la transferencia de entropía (TE), una técnica no paramétrica que permite detectar relaciones direccionales entre variables y que no ha sido utilizada antes para el estudio de la vigilia prolongada. Los resultados obtenidos concuerdan con la potencia en la banda ϴ, un marcador reconocido relacionado con la presión de sueño. Los efectos máximos de la privación del sueño se producen a partir de las 24 horas sin dormir. Durante este periodo, se producen incrementos de TE localizados en la zona anterior mientras que los decrementos principalmente se originan en la zona occipital y afectan globalmente al resto del cerebro. El promedio de estos decrementos muestra una fuerte correlación con la potencia ϴ, por lo que se podría considerar como otro marcador fiable de la presión de sueño que, además, proporciona información sobre la localización de los cambios producidos, indicando una disminución de la transferencia de información entre las regiones cerebrales.Peer ReviewedPostprint (author’s final draft

Stress assessment based on EEG univariate features and functional connectivity measures

The biological response to stress originates in the brain but involves different biochemical and physiological effects. Many common clinical methods to assess stress are based on the presence of specific hormones and on features extracted from different signals, including electrocardiogram, blood pressure, skin temperature, or galvanic skin response. The aim of this paper was to assess stress using EEG-based variables obtained from univariate analysis and functional connectivity evaluation. Two different stressors, the Stroop test and sleep deprivation, were applied to 30 volunteers to find common EEG patterns related to stress effects. Results showed a decrease of the high alpha power (11 to 12 Hz), an increase in the high beta band (23 to 36 Hz, considered a busy brain indicator), and a decrease in the approximate entropy. Moreover, connectivity showed that the high beta coherence and the interhemispheric nonlinear couplings, measured by the cross mutual information function, increased significantly for both stressors, suggesting that useful stress indexes may be obtained from EEG-based features.Peer ReviewedPostprint (author’s final draft

Automated detection of epileptic ripples in MEG using beamformer-based virtual sensors

Objective. In epilepsy, high-frequency oscillations (HFOs) are expressively linked to the seizure onset zone (SOZ). The detection of HFOs in the noninvasive signals from scalp electroencephalography (EEG) and magnetoencephalography (MEG) is still a challenging task. The aim of this study was to automate the detection of ripples in MEG signals by reducing the high-frequency noise using beamformer-based virtual sensors (VSs) and applying an automatic procedure for exploring the time-frequency content of the detected events. Approach. Two-hundred seconds of MEG signal and simultaneous iEEG were selected from nine patients with refractory epilepsy. A two-stage algorithm was implemented. Firstly, beamforming was applied to the whole head to delimitate the region of interest (ROI) within a coarse grid of MEG-VS. Secondly, a beamformer using a finer grid in the ROI was computed. The automatic detection of ripples was performed using the time-frequency response provided by the Stockwell transform. Performance was evaluated through comparisons with simultaneous iEEG signals. Main results. ROIs were located within the seizure-generating lobes in the nine subjects. Precision and sensitivity values were 79.18% and 68.88%, respectively, by considering iEEG-detected events as benchmarks. A higher number of ripples were detected inside the ROI compared to the same region in the contralateral lobe. Significance. The evaluation of interictal ripples using non-invasive techniques can help in the delimitation of the epileptogenic zone and guide placement of intracranial electrodes. This is the first study that automatically detects ripples in MEG in the time domain located within the clinically expected epileptic area taking into account the time-frequency characteristics of the events through the whole signal spectrum. The algorithm was tested against intracranial recordings, the current gold standard. Further studies should explore this approach to enable the localization of noninvasively recorded HFOs to help during pre-surgical planning and to reduce the need for invasive diagnostics.Peer ReviewedPostprint (author's final draft

Inhibition of alpha oscillations through serotonin-2A receptor activation underlies the visual effects of ayahuasca in humans

Ayahuasca is an Amazonian psychotropic plant tea typically obtained from two plants, Banisteriopsis caapi and Psychotria viridis. It contains the psychedelic 5-HT2A and sigma-1 agonist N,N-dimethyltryptamine (DMT) plus ß-carboline alkaloids with monoamine-oxidase (MAO)-inhibiting properties. Although the psychoactive effects of ayahuasca have commonly been attributed solely to agonism at the 5-HT2A receptor, the molecular target of classical psychedelics, this has not been tested experimentally. Here we wished to study the contribution of the 5-HT2A receptor to the neurophysiological and psychological effects of ayahuasca in humans. We measured drug-induced changes in spontaneous brain oscillations and subjective effects in a double-blind randomized placebo-controlled study involving the oral administration of ayahuasca (0.75 mg DMT/kg body weight) and the 5-HT2A antagonist ketanserin (40 mg). Twelve healthy, experienced psychedelic users (5 females) participated in four experimental sessions in which they received the following drug combinations: placebo+placebo, placebo+ayahuasca, ketanserin+placebo and ketanserin+ayahuasca. Ayahuasca induced EEG power decreases in the delta, theta and alpha frequency bands. Current density in alpha-band oscillations in parietal and occipital cortex was inversely correlated with the intensity of visual imagery induced by ayahuasca. Pretreatment with ketanserin inhibited neurophysiological modifications, reduced the correlation between alpha and visual effects, and attenuated the intensity of the subjective experience. These findings suggest that despite the chemical complexity of ayahuasca, 5-HT2A activation plays a key role in the neurophysiological and visual effects of ayahuasca in humans.Postprint (published version

Monitoring sleep depth: analysis of bispectral index (BIS) based on polysomnographic recordings and sleep deprivation

© 2015 Springer Science+Business Media Dordrecht The assessment and management of sleep are increasingly recommended in the clinical practice. Polysomnography (PSG) is considered the gold standard test to monitor sleep objectively, but some practical and technical constraints exist due to environmental and patient considerations. Bispectral index (BIS) monitoring is commonly used in clinical practice for guiding anesthetic administration and provides an index based on relationships between EEG components. Due to similarities in EEG synchronization between anesthesia and sleep, several studies have assessed BIS as a sleep monitor with contradictory results. The aim of this study was to evaluate objectively both the feasibility and reliability of BIS for sleep monitoring through a robust methodology, which included full PSG recordings at a baseline situation and after 40 h of sleep deprivation. Results confirmed that the BIS index was highly correlated with the hypnogram (0.89 ± 0.02), showing a progressive decrease as sleep deepened, and an increase during REM sleep (awake: 91.77 ± 8.42; stage N1: 83.95 ± 11.05; stage N2: 71.71 ± 11.99; stage N3: 42.41 ± 9.14; REM: 80.11 ± 8.73). Mean and median BIS values were lower in the post-deprivation night than in the baseline night, showing statistical differences for the slow wave sleep (baseline: 42.41 ± 9.14 vs. post-deprivation: 39.49 ± 10.27; p = 0.02). BIS scores were able to discriminate properly between deep (N3) and light (N1, N2) sleep. BIS values during REM overlapped those of other sleep stages, although EMG activity provided by the BIS monitor could help to identify REM sleep if needed. In conclusion, BIS monitors could provide a useful measure of sleep depth in especially particular situations such as intensive care units, and they could be used as an alternative for sleep monitoring in order to reduce PSG-derived costs and to increase capacity in ambulatory care.Postprint (author's final draft